January 2025

How To Cope With Sundowning Caring for a loved one who has Alzheimer’s disease or dementia can be a challenge, especially when so many symptoms are readily recognized as disease-related but not well understood. One symptom some people experience is known as “sundowning,” in which they get more confused, anxious, or agitated than usual. They may start pacing, following a caregiver from room to room, crying, shouting, or even hallucinating. This frequently happens as daylight fades, hence the name, but it can occur at any time of the day. Doctors don’t know what specifically causes sundowning, but experts do offer recommendations for caregivers to help reduce the likelihood of sundowning. This includes both things to avoid and tips for preventing it.

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Things that can help reduce sundowning: ✓ Sticking to a daily routine ✓ Getting regular exposure to sunlight ✓

Supplementing lighting indoors and outdoors, especially in winter ✓ Engaging in some physical activity every day to promote healthy sleep ✓ Turning the TV volume down (or off) ✓ Keeping household activities and conversations calm

Things that can trigger sundowning:  Getting inadequate sleep 

Consuming caffeine and sugar in the afternoon or evening  Taking a nap late in the day  Changes in diet or medications  Being hungry, dehydrated, or in pain  Spending time in an overstimulating environment

It’s important to work closely with your loved one’s doctor when it comes to sundowning or any other symptom of Alzheimer’s disease or dementia in order to address their specific situation and needs.

Visit the National Institute on Aging for more information about coping with sundowning . (Search “sundowning” at www.nia.nih.gov ).

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